Psychiatria Fennica (Nov 2022)
Consultation-liaison psychiatry in Finland today and challenges for the future
Abstract
The ongoing health and social services reform in Finland will restructure the organization of public healthcare and social welfare to 21 wellbeing services counties. Organizational models within wellbeing services counties will differ from each other and psychiatric services are going to be placed differently. Reform has raised concerns about the role of CL psychiatry (consultation-liaison psychiatry) in the future. In this article we will discuss the challenges of collaboration and consultation between psychiatric services and somatic specialties in changing operating environment. As background information some statistics from medical units of two Finnish hospitals where somatically ill patients have been referred to CL psychiatric services is explored. Also, as a description of key patient groups in CL psychiatric services the statistics of the main ICD-10 diagnoses in CL psychiatric services is presented. Medical conditions are associated significantly with increased psychological symptoms and psychiatric disorders. Therefore, different medical specialties widely use CL psychiatric services. The patients referred from somatic units form an important psychiatric patient group, which differs from the patients in psychiatric services generally. The vast majority of these patients are of working age. Continual cooperation between psychiatry and medical services should be guaranteed in the current reform of the organization of public healthcare. High-level treatment of medically ill should be ensured by maintaining general hospital psychiatry units and also transferring their skills more widely to outpatient settings.
